Individual
DR. MICHAEL JEFFREY LOGAN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
16535 W BLUEMOUND ROAD, SUITE 200, BROOKFIELD, WI 53005-5906
(262) 789-0909
(262) 821-6180
Mailing address
15065 WESTOVER ROAD, ELM GROVE, WI 53122-1541
(262) 786-1710
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
16418
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31226500
—
WI
Enumeration date
04/28/2006
Last updated
07/08/2007
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